Provider Demographics
NPI:1053562140
Name:WEATHERS, OLIVIA POWERS (DC)
Entity type:Individual
Prefix:DR
First Name:OLIVIA
Middle Name:POWERS
Last Name:WEATHERS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2386 ROUTE 4A
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NH
Mailing Address - Zip Code:03284-2307
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:71 PLEASANT STREET
Practice Address - Street 2:
Practice Address - City:NEW LONDON
Practice Address - State:NH
Practice Address - Zip Code:03257
Practice Address - Country:US
Practice Address - Phone:603-526-6522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH842-0509111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor